2f:I[703058,["/_next/static/immutable/chunks/3bhq_5eh1d760.js","/_next/static/immutable/chunks/1855-ogyi8eh4.js","/_next/static/immutable/chunks/2pfsjpn6k6zlg.js","/_next/static/immutable/chunks/26c7v3_3uwnwu.js","/_next/static/immutable/chunks/25a3ozcrvi1ff.js","/_next/static/immutable/chunks/2r4wx50nvjh_4.js","/_next/static/immutable/chunks/23fsw06hsi5b1.js","/_next/static/immutable/chunks/06_yt270h41rg.js","/_next/static/immutable/chunks/3ezsiz-7shkna.js","/_next/static/immutable/chunks/20x2y96ldu5wx.js","/_next/static/immutable/chunks/2lxntcm3pd1_h.js","/_next/static/immutable/chunks/00dgco8irq3jw.js","/_next/static/immutable/chunks/00nwe-kq0rboc.js","/_next/static/immutable/chunks/2051ffx3xzio9.js"],"PaperListPageClient"] 30:T750,Recent technologic advances in neonatal dialysis have changed current dialysis practices. The goal of this study was to define demographics, diagnoses, initial dialysis modality, modality changes, and outcomes of neonates receiving dialysis. Retrospective, multicenter cohort of neonates (≤ 30 days of age) from 26 U.S. centers, who received dialysis between 6/2017 and 5/2022. Measures of central tendency were calculated to describe the cohort stratified by the primary dialysis-related diagnosis including acute kidney injury requiring dialysis (AKI-D), stage 5 chronic kidney disease (CKD 5), hyperammonemia, and other causes. The primary outcome was death during the initial hospitalization. For the 405 neonates in this cohort, AKI-D (57%) was the most common dialysis-related diagnosis, followed by CKD 5 (29%) and hyperammonemia (11%). Most neonates (58%) had a birth weight between 2500 and 3500 g. The most common initial neonatal dialysis modality was continuous kidney replacement therapy (CKRT) with (35%) or without extracorporeal membrane oxygenation (ECMO) (36%). Only 26% of neonates received peritoneal dialysis (PD) as their initial dialysis modality. Thirty percent of neonates received more than one dialysis modality. The overall mortality was 50% (59% in AKI-D and 41% in CKD 5). Withdrawal of care was reported as the most common reason for death. The odds of death were lower for neonates with AKI-D receiving PD as the initial modality when compared to CKRT (aOR 0.28, 95% CI 0.09-0.84) or CKRT with ECMO (aOR 0.24, 95% CI 0.10-0.58), but this association was not seen in neonates with CKD 5. This multicenter, contemporary neonatal dialysis cohort shows increased use of CKRT as the initial dialysis modality but also shows that the mortality of neonates on dialysis remains high. Additional studies on modern neonatal dialysis are needed.31:Ta4c,Abstract Background Recent technologic advances in neonatal dialysis have changed current dialysis practices. The goal of this study was to define demographics, diagnoses, initial dialysis modality, modality changes, and outcomes of neonates receiving dialysis. Methods Retrospective, multicenter cohort of neonates (≤ 30 days of age) from 26 U.S. centers, who received dialysis between 6/2017 and 5/2022. Measures of central tendency were calculated to describe the cohort stratified by the primary dialysis-related diagnosis including acute kidney injury requiring dialysis (AKI-D), stage 5 chronic kidney disease (CKD 5), hyperammonemia, and other causes. The primary outcome was death during the initial hospitalization. Results For the 405 neonates in this cohort, AKI-D (57%) was the most common dialysis-related diagnosis, followed by CKD 5 (29%) and hyperammonemia (11%). Most neonates (58%) had a birth weight between 2500 and 3500 g. The most common initial neonatal dialysis modality was continuous kidney replacement therapy (CKRT) with (35%) or without extracorporeal membrane oxygenation (ECMO) (36%). Only 26% of neonates received peritoneal dialysis (PD) as their initial dialysis modality. Thirty percent of neonates received more than one dialysis modality. The overall mortality was 50% (59% in AKI-D and 41% in CKD 5). Withdrawal of care was reported as the most common reason for death. The odds of death were lower for neonates with AKI-D receiving PD as the initial modality when compared to CKRT (aOR 0.28, 95% CI 0.09–0.84) or CKRT with ECMO (aOR 0.24, 95% CI 0.10–0.58), but this association was not seen in neonates with CKD 5. Conclusions This multicenter, contemporary neonatal dialysis cohort shows increased use of CKRT as the initial dialysis modality but also shows that the mortality of neonates on dialysis remains high. Additional studies on modern neonatal dialysis are needed. Graphical abstract 25:[[["$","script","0",{"type":"application/ld+json","dangerouslySetInnerHTML":{"__html":"{\"@context\":\"https://schema.org\",\"@type\":\"CollectionPage\",\"name\":\"Hyperammonemia: condition Research & Clinical Takeaways\",\"description\":\"Explore peer-reviewed papers on Hyperammonemia (condition). Clinician-written summaries and actionable practice insights. 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Most neonates (58%) had a birth weight between 2500 and 3500 g. The most common initial neonatal dialysis modality was continuous kidney replacement therapy (CKRT) with (35%) or without extracorporeal membrane oxygenation (ECMO) (36%). Only 26% of neonates received peritoneal dialysis (PD) as their initial dialysis modality. Thirty percent of neonates received more than one dialysis modality. The overall mortality was 50% (59% in AKI-D and 41% in CKD 5). Withdrawal of care was reported as the most common reason for death. The odds of death were lower for neonates with AKI-D receiving PD as the initial modality when compared to CKRT (aOR 0.28, 95% CI 0.09-0.84) or CKRT with ECMO (aOR 0.24, 95% CI 0.10-0.58), but this association was not seen in neonates with CKD 5.","abstract":"$30","keywords":["AKI","CKRT","Neonatal dialysis","Peritoneal dialysis","Stage 5 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Lancet Child Adolesc Health 1:184–194. https://doi.org/10.1016/s2352-4642(17)30069-x","article-title":null,"journal-title":"Lancet Child Adolesc Health","doi-asserted-by":"publisher"}],"short-title":[],"update-policy":"https://doi.org/10.1007/springer_crossmark_policy","alternative-id":["7082"],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"original-title":[],"container-title":["Pediatric Nephrology"],"reference-count":24,"published-online":{"date-time":null,"timestamp":null,"date-parts":[[2026,1,13]]},"references-count":24,"short-container-title":["Pediatr Nephrol"],"is-referenced-by-count":0},"unpaywall":{"doi":"10.1007/s00467-025-07082-9","is_oa":true,"title":"Dialysis modality and mortality of the Contemporary Infant and Neonatal Dialysis (COINED) Cohort: a Pediatric Nephrology Research Consortium (PNRC) study","updated":"2026-01-15T02:17:35+00:00","published_date":"2026-01-13","best_oa_location":{"url":"https://link.springer.com/content/pdf/10.1007/s00467-025-07082-9.pdf","pmh_id":null,"url_for_pdf":"https://link.springer.com/content/pdf/10.1007/s00467-025-07082-9.pdf","url_for_landing_page":"https://doi.org/10.1007/s00467-025-07082-9"}}},"created_at":"2026-01-20T15:55:50.695Z","updated_at":"2026-01-20T15:55:50.695Z","tags":[{"paper_doi":"10.1007/s00467-025-07082-9","tag_type":"age_group","value":"neonate","value_numeric":null},{"paper_doi":"10.1007/s00467-025-07082-9","tag_type":"category","value":"Urology & Nephrology","value_numeric":null},{"paper_doi":"10.1007/s00467-025-07082-9","tag_type":"condition","value":"Acute Kidney Injury","value_numeric":null},{"paper_doi":"10.1007/s00467-025-07082-9","tag_type":"condition","value":"Hyperammonemia","value_numeric":null},{"paper_doi":"10.1007/s00467-025-07082-9","tag_type":"condition","value":"Stage 5 Chronic Kidney Disease","value_numeric":null},{"paper_doi":"10.1007/s00467-025-07082-9","tag_type":"impact_flag","value":"limited_evidence","value_numeric":null},{"paper_doi":"10.1007/s00467-025-07082-9","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1007/s00467-025-07082-9","tag_type":"modality","value":"Continuous Kidney Replacement Therapy","value_numeric":null},{"paper_doi":"10.1007/s00467-025-07082-9","tag_type":"modality","value":"Peritoneal Dialysis","value_numeric":null},{"paper_doi":"10.1007/s00467-025-07082-9","tag_type":"sample_size","value":"n=405","value_numeric":405},{"paper_doi":"10.1007/s00467-025-07082-9","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1007/s00467-025-07082-9","tag_type":"study_design","value":"Retrospective Cohort Study","value_numeric":null},{"paper_doi":"10.1007/s00467-025-07082-9","tag_type":"warning","value":"Observational design with likely confounding by illness severity; associations should not be interpreted as causal.","value_numeric":null},{"paper_doi":"10.1007/s00467-025-07082-9","tag_type":"warning","value":"Study design classification inferred from methods as a retrospective multicenter cohort.","value_numeric":null}],"summaries":{"what_studied":"Multicenter retrospective cohort of 405 neonates (≤30 days) from 26 U.S. centers (6/2017–5/2022) who started dialysis, describing diagnoses, initial modality, modality changes, and in-hospital mortality. Primary outcome was death during the initial hospitalization, with analyses stratified by AKI requiring dialysis (AKI-D), CKD 5, and hyperammonemia.","key_result":"Overall, 203/405 (50%) died; mortality was 138/232 (59%) in AKI-D and 50/119 (42%) in CKD 5. In AKI-D, initial PD was associated with lower odds of death versus CKRT (aOR 0.28, 95% CI 0.09–0.84) and CKRT with ECMO (aOR 0.24, 95% CI 0.10–0.58); withdrawal of care was the most common reason for death (63%).","limitations":"Retrospective EMR abstraction with site-defined diagnoses/indications risks selection and misclassification bias, and some key data were incomplete (e.g., only 63% had weight within 72 h pre-initiation). Initial modality likely reflected illness severity, and several confounders could not be adjusted due to rarity or collinearity, limiting causal inference.","practice_takeaway":"Among neonates with AKI-D, starting with PD was associated with lower adjusted odds of in-hospital death than CKRT (with or without ECMO), while no modality difference was seen in CKD 5. Contemporary practice favors CKRT as the initial modality, yet mortality remains high; modality choice should weigh these observed associations alongside patient severity."}}],"initialOffset":1,"fetchConfig":{"kind":"tags","tags":[{"tag_type":"condition","value":"Hyperammonemia"}]},"breadcrumbItems":[{"name":"Home","href":"/"},{"name":"Research Hub","href":"/hub"},{"name":"Conditions","href":"/hub/tag/condition"},{"name":"Hyperammonemia"}],"hrefConfig":{"basePath":"/hub/papers","webViewQueryParams":{"hub_ctx":"tag","hub_tag_type":"condition","hub_tag_value":"Hyperammonemia"}}}]]

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